“procedure that could triple a patient’s five-year-survival odds—from 5% to 15%—albeit with a poor quality of life”
I’m not a doctor but I wouldn’t hang around and go through hell for odds like that. Maybe I was a doctor in another life? More likely I’m just the typical, normal guy.
I’ve been saying this for years. MIL is 93 and has 7% kidney function and probable leukemia. But she doesn’t want to die—I can feel dialysis and chemo knocking on my door. What a loon!
Unfortunately, it’s just one small step from you making this decision for yourself and the the Obamacare government bean counters making the decision for you.
Doctors know their industry intimately and are making decisions with information that is usually not available for patients or their families. With a recent cancer scare in my life, I told my wife I would not be breaking the bank to chase every last possibility. Fortunately for me, it turned out the tumor was not cancerous but it did cost me my left kidney through a surgical removal of both the kidney and the tumor.
There are a lot of doctors — well, OK, two or three that I know, that I respect. Most doctors are going to tell patients, especially patients with the means to pay, about all the new techniques and all the advances and all the treatments. Most doctors are going to encourage those patients who can afford to do so to try the advanced treatments. Doctors themselves will not be fooled by this tactic.
Our house is all brick veneer. The bricklayers made a few mistakes and bobbles here and there, especially on the gable ends, which are hard to do. My wife, who is a little bit obsessive-compulsive could see nothing except the mistakes. She called a couple of bricklayers out to see if they could correct it. The guys looked at the work and began to tell her how awful the job was and how the first crew had just screwed up everything.
I said, “What do you expect them to tell you when they can make money on it?” Of course, one of the guys still got a job, and I had to write a check.
IIRC, the average doctor dies at 48.
This is a subjedct that my wife and I have given a lot of thought to. I am a cancer survivor, having lost my left kidney to renal cell carcinoma. I now have stage 4 kidney disease in my remaining kidney. No big deal, really. I’m taking care of myself and may never progress beyong stage 4. But IF I do I’ve decided that I will not rely on dialysis to keep me alive. My mother was on dialysis for the last 2 years of her life. Years that she spent dying, not living. No thanks. Not for me. Ditto with the cancer. If RCC ever metastasizes treatment options are limited, brutal and largely ineffective other than surgery. Therefore I’ve decided that if I’m faced with that and surgery isn’t successful I’ll do what the Dr. in the articel did. Go home and live for as long as I have left.
There is an upside but several downsides for doctors with this.
The upside is the obvious, that they know what the prognosis is, the damage done, and the quality of life if they survive for a while.
But the downside is that they are often just as ignorant about medical breakthroughs as ordinary people. These breakthroughs are often extraordinary, and can sometimes completely arrest or nullify previously terminal illnesses relatively quickly and easily.
And ironically, even if they are still experimental, doctors have enough “pull” to get in on the “new stuff.” Often they would be well greeted in such an experiment, because it can be assumed they will keep their objectivity, and give a learned opinion as to treatment effectiveness.
The other downside is all too human.
People think they empathize with others, imagining how they would feel in their situation. And they, even doctors, are almost universally wrong.
The best example of this was of two green soldiers, call them Privates Smith and Jones, sent into combat for the first time. In the heat of battle, Jones is grazed by a bullet on the top of his head, knocked out cold by the force, and is bleeding profusely all over his head and upper body as is common with even minor head wounds such as this.
Smith is horrified by how his friend Jones looks, and imagines that he is barely alive and in horrible pain, his brain destroyed, and otherwise gone already. So Smith decides to “do the honorable thing” and put Jones “out of his misery”.
About to shoot his friend, he is startled when Jones comes to, and seeing a rifle pointed at him, takes off running, with Smith hot on his heels, trying to get him to hold still so he can shoot the poor wounded man who is at death’s door and doesn’t even know it. But Jones *does* know it, which is why he is running as fast as he can to get away from the pseudo-empathetic dummy with a rifle.
Doctors are far too often in the same position as Smith.
They see people suffer. Or at least they think they do. But like anyone else, they can’t really scale how much someone else is suffering. But they assume they do, and they say to themselves that they don’t ever want to suffer like that.
“I would rather die than suffer like that.”
It’s a tough call. I worked with two men. One was young with a young family. The other man was in his late ‘60s.
They were both diagnosed with colon cancer. The disease followed the same course in both.
Understandably, the young man when all out for chemo, etc.
The older man opted for comfort and no chemo.
They died within weeks of each other.
On the other hand, a friend had a malignant tumor in his heart. Chemo and radiation destroyed the tumor, and he fully recovered, but what a long gruesome trial!!!
My own mother lived with untreated colon cancer for more than 10 years. She lived to 82.
Educating ourselves to make informed decisions is essential.
And which I found out later, at his deathbed, that I had no idea what that meant.
After 15 days on a respirator they told me they had to take him off, or he would be stuck on a respirator until he died; and the doctor said he probably wouldn't survive if they took him off. I had to have a talk with him and give him the news.
Now understand, he'd been unable to communicate verbally the whole time he'd been hospitalized, and we were communicating by me talking, him blinking and squeezing my hand. And at the end, he made the decision, to the extent he had one.
A word of advice - talk this sort of thing out with your kids before the need arises. I guarantee, they need more clear advice than a quip about not being a vegetable.
From the FWIW Department, my doctor, a woman in her late thirties, just quit and is moving to Costa Rica to practice medicine.
That said, I work in the health care field..and I totally agree. I've seen enough....
“During their last moments, they know, for instance, that they don’t want someone breaking their ribs by performing cardiopulmonary resuscitation (which is what happens when CPR is done right).”
This sounds like BS. Who in their right mind, liability wise, would perform this on anyone if this were true?
Definitely have mixed feelings about this statement.
I think it is mostly true that we used to be much more accepting of death as a part of life than we are now.
On the other hand, one can't help but notice the inherent propaganda value of such a statement. It will be yet another method to deny people the care they need or desire once Obamacare fully kicks in.
A Russian friend of mine recalls the way the Soviet government would use such tactics. Whenever there was a food shortage, they would line the shelves of the markets with books about the virtues and health benefits of fasting.
If presented the opportunity, I intend to die gracefully. I don't see the value in merely kicking the can down the road with futile treatment. I accept death as a part of life, and don't see the value of surviving at any cost. I don't want to to live a poor quality of life merely for the sake of being alive.
However, I am certain that the Obamacare bureaucrats will use this rationale to deny care to those who do want it. And that is frightening.
Actually, doctors and elected officials, when it is their life at stake tend to go to natural herbal medicine, get cured, and live on for a few more decades.
Some years ago Mrs. OldPossum and I consulted with our attorney regarding end-of-life care and he provided us with an elaborate questionnaire as to what we wanted done in certain instances. I selected no heroic treatments, none at all.
The advance directive has teeth in it, unlike a lot of stuff stuck on wills. My wife has health power-of-attorney and if the hospital ignores her stated wishes on my behalf she can take them to court.
Now, there’s a language they understand.